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Zheng H, Wang Q, Chen F. Correlation between serum beta-human chorionic gonadotropin levels and thyroid metabolic function in pregnant women with hyperemesis gravidarum. CHINESE J PHYSIOL 2023; 66:359-364. [PMID: 37929347 DOI: 10.4103/cjop.cjop-d-23-00045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
As previously demonstrated, serum beta-human chorionic gonadotropin (β-hCG) is linked to identifying early gestational abnormalities. This research was aimed at investigating the correlation between serum β-hCG levels and thyroid metabolic function in pregnant women with hyperemesis gravidarum (HG). Ninety-one pregnant women with HG were selected as the study group and divided into early pregnancy (EP), mid-pregnancy (MP), and late pregnancy (LP) groups according to their gestational weeks, while 84 normal pregnant women were selected as the control group. Venous blood was collected from pregnant women in both groups and serum β-hCG levels were measured by chemiluminescent immunoassay. The levels of free thyroxine (FT4), free triiodothyronine (FT3), thyroid-stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), thyroid-stimulating hormone receptor antibody (TRAb), and thyroglobulin antibody (TgAb) were tested by chemiluminescent microparticle immunoassay. Visual analog scale (VAS) scores were utilized to assess the degree of HG. Pearson analysis was implemented to measure the correlations between serum β-hCG levels and serum FT3, FT4, TSH, TPOAb, TRAb, TgAb, as well as VAS scores and the correlations between β-hCG, FT3, FT4, TSH, TPOAb, TRAb, TgAb, as well as VAS scores and gestation period. The receiver operating characteristic (ROC) curve was plotted to analyze the diagnostic values of thyroid hormones, thyroid-related antibodies, and β-hCG levels for HG. Versus those in the control group, β-hCG, FT3, FT4, TPOAb, TRAb, TgAb levels, and VAS scores were higher and TSH levels were lower in the study group. Versus those in the EP group, β-hCG, FT3, FT4, TPOAb, TRAb, TgAb levels, and VAS scores of pregnant women in the MP and LP groups were decreased, and TSH levels were increased. Serum β-hCG levels of pregnant women with HG were positively correlated with FT3, FT4, TPOAb, TRAb, TgAb, and VAS scores and negatively correlated with TSH levels. Serum β-hCG, FT3, FT4, TPOAb, TRAb, TgAb levels, and VAS scores of pregnant women with HG had a negative correlation with the gestation period, while TSH levels had a positive correlation with the gestation period. The ROC curve analysis showed that β-hCG and thyroid function-related indicators were of high clinical values in the diagnosis of HG. Collectively, our article suggests that serum β-hCG expression of pregnant women with HG is abnormally elevated and closely related to the degree of HG and hyperthyroidism. In addition, β-hCG and thyroid function-related indicators have certain diagnostic efficacy for HG.
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Affiliation(s)
- Haiyan Zheng
- Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Qian Wang
- Department of Endocrinology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Feng Chen
- Department of Traditional Chinese Medicine, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, China
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Murphy HM, Fetter CM, Snow NJ, Chaves AR, Downer MB, Ploughman M. Lower corticospinal excitability and greater fatigue among people with multiple sclerosis experiencing pain. Mult Scler J Exp Transl Clin 2023; 9:20552173221143398. [PMID: 36636581 PMCID: PMC9830099 DOI: 10.1177/20552173221143398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/17/2022] [Indexed: 01/08/2023] Open
Abstract
Introduction Persons with multiple sclerosis (MS) frequently report pain that negatively affects their quality of life. Evidence linking pain and corticospinal excitability in MS is sparse. We aimed to (1) examine differences in corticospinal excitability in MS participants with and without pain and (2) explore predictors of pain. Methods Sixty-four participants rated their pain severity on a visual analog scale (VAS). Transcranial magnetic stimulation (TMS) and validated clinical instruments characterized corticospinal excitability and subjective disease features like mood and fatigue. We retrieved information on participants' prescriptions and disability status from their clinical records. Results Fifty-five percent of participants reported pain that affected their daily functioning. Persons with pain had significantly greater fatigue and lower area under the excitatory motor evoked potential (MEP) recruitment curve (eREC AUC), a measure of total corticospinal excitability. After controlling for age, disability status, and pain medications, increased fatigue and decreased eREC AUC together explained 40% of the variance in pain. Discussion Pain in MS is multifactorial and relates to both greater fatigue and lesser corticospinal excitability. Future work should better characterize relationships between these outcomes to develop targeted pain interventions such as neuromodulation. Summary We examined pain in MS. Individuals with pain had higher fatigue and lower corticospinal excitability than those without pain. These outcomes significantly predicted self-reported pain.
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Affiliation(s)
- Hannah M. Murphy
- Recovery & Performance Laboratory, Faculty of
Medicine, Memorial University of Newfoundland, St John's, Newfoundland and
Labrador, Canada
| | - Christopher M. Fetter
- Recovery & Performance Laboratory, Faculty of
Medicine, Memorial University of Newfoundland, St John's, Newfoundland and
Labrador, Canada
| | - Nicholas J. Snow
- Recovery & Performance Laboratory, Faculty of
Medicine, Memorial University of Newfoundland, St John's, Newfoundland and
Labrador, Canada
| | - Arthur R. Chaves
- Recovery & Performance Laboratory, Faculty of
Medicine, Memorial University of Newfoundland, St John's, Newfoundland and
Labrador, Canada
| | - Matthew B. Downer
- Recovery & Performance Laboratory, Faculty of
Medicine, Memorial University of Newfoundland, St John's, Newfoundland and
Labrador, Canada
| | - Michelle Ploughman
- Recovery & Performance Laboratory, Faculty of
Medicine, Memorial University of Newfoundland, St John's, Newfoundland and
Labrador, Canada,Michelle Ploughman, Recovery
& Performance Laboratory, Faculty of Medicine, Memorial University of
Newfoundland, LA Miller Centre, 100 Forest Road, St. John's, NL, A1A1E5, Canada.
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Zhang Z, Zhang Y, Huang C, Huo J. Comparison of Clinical Efficacy and Recovery Effect between Lateral and Posterior Foraminoscopy and PELD in LDH Patients. CONTRAST MEDIA & MOLECULAR IMAGING 2022; 2022:8135322. [PMID: 35833062 PMCID: PMC9252691 DOI: 10.1155/2022/8135322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 05/26/2022] [Accepted: 06/02/2022] [Indexed: 11/29/2022]
Abstract
In order to analyze the clinical efficacy and recovery of lumbar disc herniation (LDH) treated by lateral and posterior foraminoscopy and posterior approach foraminoscopy (PELD), the comparison of clinical efficacy and recovery effect between lateral and posterior foraminoscopy and PELD in LDH patients was conducted. A total of 96 LDH patients admitted to our hospital from July 2020 to July 2021 were selected, and the lateral and posterior foraminoscopy group and PELD group were, respectively, established according to different surgical intervention methods. The lateral posterior foraminoscopy group is treated with lateral posterior foraminoscopy intervention, and the PELD group is treated with posterior foraminoscopy intervention. The intraoperative and postoperative indicators of the two groups were observed, and the pain improvement, lumbar function, clinical efficacy, and incidence of adverse complications were compared between the two groups before and 3 months after surgery. The Spearman correlation coefficient is used to analyze the correlation between visual analogue scale (VAS) score, lumbar function (ODI) score, and the incidence of complications. For patients with LDH in implementing lientang road intervertebral foramen mirror, the clinical efficacy of the intervertebral foramen to a rear mirror was more apparent. It demonstrates that the treatment can reduce intraoperative blood loss, shorten hospitalization time, improve lumbar vertebral function, and reduce a patient's risk of complications.
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Affiliation(s)
- Zhimin Zhang
- Shanxi Medical University, Taiyuan 030000, China
| | - Yaning Zhang
- Shanxi Medical University, Linfen Hospital, Taiyuan 041000, China
| | - Chunxia Huang
- Shanxi Medical University, Linfen Hospital, Taiyuan 041000, China
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Thwaites S, Thewlis D, Hall K, Rickman M. Investigating and defining outcomes of suprapatellar versus infrapatellar intramedullary nailing of tibial shaft fractures: a protocol for a pilot randomised controlled trial. Pilot Feasibility Stud 2022; 8:110. [PMID: 35619162 PMCID: PMC9134682 DOI: 10.1186/s40814-022-01057-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/03/2022] [Indexed: 11/24/2022] Open
Abstract
Background Anterior knee pain is often reported following intramedullary nailing of tibial shaft fractures. The aetiology remains unclear, but the surgical approach may play an important role. To date, no biomechanically validated method exists to assess patient outcomes specific to anterior knee pain in this cohort. The central aims of this study are to (1) evaluate the feasibility of a full-scale randomised controlled trial (RCT) investigating the influence of surgical approach on intramedullary nailing of tibial shaft fractures (suprapatellar versus infrapatellar nailing), (2) explore differences in clinical outcomes between the approaches, and (3) explore the development of a biomechanically validated methodology for assessing post-operative anterior knee pain and knee function specific to intramedullary nailing of tibial shaft fractures. Methods This pilot study will follow a prospective randomised controlled design at the Royal Adelaide Hospital and The Queen Elizabeth Hospital (South Australia). This study aims to recruit 60 patients between 18 and 60 years old who will be randomly assigned to either the suprapatellar or infrapatellar approach following a decision for intramedullary surgical fixation by the treating surgeon. All nails in this study will be Stryker T2 Alpha nails. Patients will undergo standard radiograph, magnetic resonance imaging, and clinical assessments in-line with their standard operative care, and complete a number of patient-reported and performance-based outcome measures. Performance-based outcome measures will be assessed utilising three-dimensional motion capture techniques. Follow-up time points are 3, 6, 12, and 18 months. Feasibility outcomes include ability to meet enrolment and retention metrics, compliance with all questionnaires and assessment procedures, and the occurrence of any adverse events. The primary clinical outcome is the incidence of anterior knee pain at 12 months after surgery. Discussion This study will establish the feasibility and inform the design of a large-scale RCT. Evaluation of all clinical data and patient outcomes will lead to the development of a new tool for assessing patient outcomes in this cohort. Limitations of the study include an unpredictable enrolment rate and loss to follow-up, small sample size, and the unknown ability of three-dimensional motion analysis to pick up the effects of anterior knee pain after tibial nailing. Trial registration This trial was prospectively registered on the 7 February 2020 on ANZCTR, ACTRN12620000109909.
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Affiliation(s)
- Simon Thwaites
- Centre for Orthopaedic & Trauma Research, The University of Adelaide, Adelaide, SA, Australia.
| | - Dominic Thewlis
- Centre for Orthopaedic & Trauma Research, The University of Adelaide, Adelaide, SA, Australia
| | - Kelly Hall
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia
| | - Mark Rickman
- Centre for Orthopaedic & Trauma Research, The University of Adelaide, Adelaide, SA, Australia.,Department of Orthopaedics & Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia
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5
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Byrom B, Elash CA, Eremenco S, Bodart S, Muehlhausen W, Platko JV, Watson C, Howry C. Measurement Comparability of Electronic and Paper Administration of Visual Analogue Scales: A Review of Published Studies. Ther Innov Regul Sci 2022; 56:394-404. [PMID: 35142989 PMCID: PMC8964617 DOI: 10.1007/s43441-022-00376-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/20/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Visual analogue scales (VASs) are used in a variety of patient-, observer- and clinician-reported outcome measures. While typically included in measures originally developed for pen-and-paper completion, a greater number of clinical trials currently use electronic approaches to their collection. This leads researchers to question whether the measurement properties of the scale have been conserved during the migration to an electronic format, particularly because electronic formats often use a different scale length than the 100 mm paper standard. METHODS We performed a review of published studies investigating the measurement comparability of paper and electronic formats of the VAS. RESULTS Our literature search yielded 26 studies published between 1997 and 2018 that reported comparison of paper and electronic formats using the VAS. After excluding 2 publications, 23 of the remaining 24 studies included in this review reported electronic formats of the VAS (eVAS) and paper formats (pVAS) to be equivalent. A further study concluded that eVAS and pVAS were both acceptable but should not be interchanged. eVAS length varied from 21 to 200 mm, indicating that 100 mm length is not a requirement. CONCLUSIONS The literature supports the hypothesis that eVAS and pVAS provide comparable results regardless of the VAS length. When implementing a VAS on a screen-based electronic mode, we recommend following industry best practices for faithful migration to minimise the likelihood of non-comparability with pVAS.
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Affiliation(s)
- Bill Byrom
- Signant Health, Ground Floor, Waterfront Embankment, Manbre Road, Hammersmith, London, W6 9RH, UK.
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6
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Papapetropoulos S, Pontius A, Finger E, Karrenbauer V, Lynch DS, Brennan M, Zappia S, Koehler W, Schoels L, Hayer SN, Konno T, Ikeuchi T, Lund T, Orthmann-Murphy J, Eichler F, Wszolek ZK. Adult-Onset Leukoencephalopathy With Axonal Spheroids and Pigmented Glia: Review of Clinical Manifestations as Foundations for Therapeutic Development. Front Neurol 2022; 12:788168. [PMID: 35185751 PMCID: PMC8850408 DOI: 10.3389/fneur.2021.788168] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/14/2021] [Indexed: 12/11/2022] Open
Abstract
A comprehensive review of published literature was conducted to elucidate the genetics, neuropathology, imaging findings, prevalence, clinical course, diagnosis/clinical evaluation, potential biomarkers, and current and proposed treatments for adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), a rare, debilitating, and life-threatening neurodegenerative disorder for which disease-modifying therapies are not currently available. Details on potential efficacy endpoints for future interventional clinical trials in patients with ALSP and data related to the burden of the disease on patients and caregivers were also reviewed. The information in this position paper lays a foundation to establish an effective clinical rationale and address the clinical gaps for creation of a robust strategy to develop therapeutic agents for ALSP, as well as design future clinical trials, that have clinically meaningful and convergent endpoints.
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Affiliation(s)
- Spyros Papapetropoulos
- Vigil Neuroscience, Inc, Cambridge, MA, United States
- Massachusetts General Hospital, Boston, MA, United States
- *Correspondence: Spyros Papapetropoulos
| | | | - Elizabeth Finger
- Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Virginija Karrenbauer
- Neurology Medical Unit, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - David S. Lynch
- National Hospital for Neurology and Neurosurgery, London, United Kingdom
| | | | | | | | - Ludger Schoels
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University Hospital Tuebingen, Tuebingen, Germany
- German Research Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Stefanie N. Hayer
- Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research and Center of Neurology, University Hospital Tuebingen, Tuebingen, Germany
- German Research Center for Neurodegenerative Diseases, Tuebingen, Germany
| | - Takuya Konno
- Brain Research Institute, Niigata University, Niigata, Japan
| | - Takeshi Ikeuchi
- Brain Research Institute, Niigata University, Niigata, Japan
| | - Troy Lund
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, United States
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7
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Scherder RJ, Prins AJ, van Dorp MJ, van Klaveren C, Cornelisz I, Killestein J, Weinstein H. Pain, cognition and disability in advanced multiple sclerosis. Scand J Pain 2021; 21:754-765. [PMID: 34469640 DOI: 10.1515/sjpain-2021-0067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES In patients with multiple sclerosis (MS), a relationship between physical disability and pain has been observed. In addition a relationship between physical disability and cognition in MS has been suggested. However, cognitive functions and pain appear not to be correlated in MS patients. Therefore, we examined whether a possible relationship between pain and cognitive functioning may exist, and if so, if such a relationship is mediated by physical disability. METHODS Forty-five MS patients with chronic pain, and in an advanced stage of the disease were included. Physical disabilities were assessed by the Expanded Disability Status Scale (EDSS). Episodic memory was assessed by means of the Eight Words test, and Face and Picture Recognition. Executive functions (EF) were examined by Digit Span Backward for working memory, and the Rule Shift Cards and Category Fluency test for cognitive flexibility. Pain Intensity and Pain Affect were assessed by means of visual analogue scales and one verbal pain scale and mood (depression, anxiety) by the Beck Depression Inventory and the Symptom Check List (SCL-90). The research questions were analyzed by means of regression analyses and the Sobel test for mediation. RESULTS A significant relationship was found between Pain Affect and EF, but that relationship was not mediated by physical disabilities (EDSS). In addition, Pain Intensity and EF showed a significant relationship but only in combination with physical disabilities (EDSS). Finally, mood was related to pain affect. DISCUSSION The findings suggest that the lower the EF, exclusively or in combination with more physical disabilities, the more the patient may suffer from pain. IMPLICATIONS The more one is cognitively and physically impaired, the more one might suffer from pain, and, the less one is able to communicate pain. The latter could put MS patients at risk for underdiagnosing and undertreatment of pain.
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Affiliation(s)
- Rogier J Scherder
- Medical Faculty, Vrije Universiteit, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | | | | | - Chris van Klaveren
- Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Ilja Cornelisz
- Department of Clinical Neuropsychology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Joep Killestein
- Department of Neurology, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Henry Weinstein
- Department of Neurology, OLVG location West, Amsterdam, The Netherlands
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Alexander S, Peryer G, Gray E, Barkhof F, Chataway J. Wearable technologies to measure clinical outcomes in multiple sclerosis: A scoping review. Mult Scler 2021; 27:1643-1656. [PMID: 32749928 PMCID: PMC8474332 DOI: 10.1177/1352458520946005] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/01/2020] [Accepted: 07/06/2020] [Indexed: 11/15/2022]
Abstract
Wearable technology refers to any sensor worn on the person, making continuous and remote monitoring available to many people with chronic disease, including multiple sclerosis (MS). Daily monitoring seems an ideal solution either as an outcome measure or as an adjunct to support rater-based monitoring in both clinical and research settings. There has been an increase in solutions that are available, yet there is little consensus on the most appropriate solution to use in either MS research or clinical practice. We completed a scoping review (using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines) to summarise the wearable solutions available in MS, to identify those approaches that could potentially be utilised in clinical trials, by evaluating the following: scalability, cost, patient adaptability and accuracy. We identified 35 unique products that measure gait, cognition, upper limb function, activity, mood and fatigue, with most of these solutions being phone applications.
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Affiliation(s)
- Sarah Alexander
- Queen Square MS Centre and Department of
Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain
Sciences, University College London, London, UK
| | - Guy Peryer
- School of Health Sciences, University of East
Anglia, Norwich, UK
| | - Emma Gray
- The Multiple Sclerosis Society, London, UK
| | - Frederik Barkhof
- Queen Square MS Centre and Department of
Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain
Sciences, University College London, London, UK/Centre for Medical Image
Computing (CMIC), Department of Medical Physics and Biomedical Engineering,
University College London, London, UK/National Institute for Health Research
(NIHR), Biomedical Research Centre, University College London Hospitals
(UCLH), London, UK/Department of Radiology and Nuclear Medicine, VU
University Medical Centre, Amsterdam, The Netherlands
| | - Jeremy Chataway
- Queen Square MS Centre and Department of
Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain
Sciences, University College London, London, UK/National Institute for
Health Research (NIHR), Biomedical Research Centre, University College
London Hospitals (UCLH), London, UK/MRC CTU at UCL, Institute of Clinical
Trials and Methodology, University College London, London, UK
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9
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Gromisch ES, Turner AP, Haselkorn JK, Lo AC, Agresta T. Mobile health (mHealth) usage, barriers, and technological considerations in persons with multiple sclerosis: a literature review. JAMIA Open 2021; 4:ooaa067. [PMID: 34514349 PMCID: PMC8423420 DOI: 10.1093/jamiaopen/ooaa067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 10/01/2020] [Accepted: 11/18/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Persons with multiple sclerosis (MS) can face a number of potential healthcare-related barriers, for which mobile health (mHealth) technology can be potentially beneficial. This review aimed to understand the frequency, current uses, and potential barriers with mHealth usage among persons with MS. METHODS A query string was used to identify articles on PubMed, MEDLINE, CINAHL, and IEEE Xplore that were published in English between January 2010 and December 2019. Abstracts were reviewed and selected based on a priori inclusion and exclusion criteria. Fifty-nine peer-reviewed research studies related to the study questions are summarized. RESULTS The majority of persons with MS were reported as using smartphones, although rates of mHealth utilization varied widely. mHealth usage was grouped into 3 broad categories: (1) disability and symptom measurement; (2) interventions and symptom management; and (3) tracking and promoting adherence. While there have been an increasing number of mHealth options, certain limitations associated with MS (eg, poor dexterity, memory problems) may affect usage, although including persons with MS in the design process can address some of these issues. DISCUSSION Given the increased attention to mHealth in this population and the current need for telehealth and at home devices, it is important that persons with MS and healthcare providers are involved in the development of new mHealth tools to ensure that the end product meets their needs. Considerations for addressing the potential mHealth use barriers in persons with MS are discussed.
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Affiliation(s)
- Elizabeth S Gromisch
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, Connecticut, USA
- Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut, USA
- Department of Medical Sciences, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, Connecticut, USA
- Department of Neurology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Aaron P Turner
- Multiple Sclerosis Center for Excellence West, Veterans Affairs, Seattle, Washington, USA
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, Washington, USA
- Department of Rehabilitative Medicine, University of Washington, Seattle, Washington, USA
| | - Jodie K Haselkorn
- Multiple Sclerosis Center for Excellence West, Veterans Affairs, Seattle, Washington, USA
- Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, Washington, USA
- Department of Rehabilitative Medicine, University of Washington, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Albert C Lo
- Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, Connecticut, USA
| | - Thomas Agresta
- Department of Family Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
- Center for Quantitative Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
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10
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Panagopoulou Z, Artemiadis AK, Chrousos GP, Darviri C, Anagnostouli MC. Pythagorean Self-Awareness Intervention for Multiple Sclerosis Patients: A Quasi-Experimental Pragmatic Trial. Arch Clin Neuropsychol 2021; 37:125-132. [PMID: 34128954 DOI: 10.1093/arclin/acab044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Multiple sclerosis (MS) is an autoimmune disorder of the central nervous system affecting patients' well-being and quality of life. Pythagorean Self-Awareness Intervention (PSAI) is a novel non-pharmaceutical intervention with significant benefits both in MS and other chronic diseases. In this study, the longstanding effectiveness of PSAI was investigated. METHOD This was a two-arm quasi-experimental pragmatic trial in relapsing-remitting MS patients (23 in the PSAI and 21 in the control group). PSAI patients received an 8-week training period and then they performed PSAI at home for another 16 weeks. Assessments took place at baseline, 8 weeks, and 24 weeks. These included cognition, fatigue, perceived stress, and hair cortisol. RESULTS Significant group × time interactions favoring PSAI were found during the first 8-week period for information processing speed, fatigue, and perceived stress. However, only verbal memory was found to be significantly improved in the PSAI group during the 24-week follow-up period. There were no significant group × time differences with respect to hair cortisol. No side effects were noted and compliance was excellent. CONCLUSIONS PSAI was mostly effective during the first 8-week training period. Its benefits worn out during the non-training period, albeit we observed a delayed significant improvement of verbal memory. Our findings will help to further refine the technique, either by extending the training period and/or by including booster sessions, throughout the PSAI treatment. This study provided Class III evidence for PSAI.
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Affiliation(s)
- Zacharo Panagopoulou
- Postgraduate Program "The Science of Stress and Health Promotion," Medical School, National Kapodistrian University of Athens, Athens, Greece
| | | | - George P Chrousos
- 1st Department of Pediatrics, Aghia Sophia Children's Hospital, Medical School, National Kapodistrian University of Athens, Athens, Greece
| | - Christina Darviri
- Postgraduate Program "The Science of Stress and Health Promotion," Medical School, National Kapodistrian University of Athens, Athens, Greece
| | - Maria C Anagnostouli
- 1st Department of Neurology, Aeginition Hospital, Medical School, National Kapodistrian University of Athens, Athens, Greece
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11
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Sellitto G, Morelli A, Bassano S, Conte A, Baione V, Galeoto G, Berardi A. Outcome measures for physical fatigue in individuals with multiple sclerosis: a systematic review. Expert Rev Pharmacoecon Outcomes Res 2021; 21:625-646. [PMID: 33504225 DOI: 10.1080/14737167.2021.1883430] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Physical fatigue can be a common reason for early retirement or sick leave since it appears in the earliest stages of multiple sclerosis (MS). Therefore, a prompt and accurate diagnosis is essential. This systematic review aims to identify and describe the instruments used to assess physical fatigue in MS patients with consideration for the languages used to validate the instruments and their methodological qualities. AREA COVERED This study has been carried out through 'Medline,' 'Scopus,' 'Cinhal,' and 'Web of Science' databases for all the papers published before 24 January 2020. Three independent authors have chosen the eligible studies based upon pre-set criteria of inclusion. Data collection, data items, and assessment of the risk of bias: the data extraction approach was chosen based on the Cochrane Methods. For data collection, the authors followed the recommendations from the COSMIN initiative. Study quality and risk of bias were assessed using the COSMIN Check List. EXPERT OPINION 119 publications have been reviewed. The 45 assessment scales can be divided into specific scales for physical fatigue and specific scales for MS. The most popular tools are the Fatigue Severity Scale and the Modified Fatigue Impact Scale.
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Affiliation(s)
| | | | | | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.,IRCCS Neuromed Pozzili, Italy
| | - Viola Baione
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Giovanni Galeoto
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Anna Berardi
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
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12
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Higashikawa F, Kanno K, Ogata A, Sugiyama M. Reduction of fatigue and anger-hostility by the oral administration of 5-aminolevulinic acid phosphate: a randomized, double-blind, placebo-controlled, parallel study. Sci Rep 2020; 10:16004. [PMID: 32994490 PMCID: PMC7525460 DOI: 10.1038/s41598-020-72763-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 08/30/2020] [Indexed: 11/20/2022] Open
Abstract
Although large populations feel fatigue, the standardized medicinal therapy is currently absent. In this study, we determined whether 5-aminolevulinic acid (5-ALA) supplementation alleviates the feeling of fatigue in healthy subjects who feel chronic physical tiredness. Males and females between ages of 20 and 64 who felt physical fatigue on a daily basis, with a visual analogue scale (VAS) for fatigue ≥ 40 mm, a T-score of Fatigue-Inertia in the Profile of Mood States—Second Edition—Adult (POMS2-A) ≥ 50, and a T-score of Vigor-Activity in POMS2-A ≤ 60 were recruited. Seventy eligible participants were randomly assigned to either a 5-ALA or a placebo group. During the 8 weeks of consumption, the subjects completed VAS questionnaires for fatigue and POMS2-A at 4-week intervals. The VAS values for overall feeling of fatigue and feeling of work-related fatigue, and the Anger-Hostility subscale of POMS2-A were decreased by 5-ALA with significant time × group interaction effects (p = 0.040, 0.020, and 0.045, respectively). Besides, the 5-ALA group showed significant differences in Fatigue-Inertia, Depression-Dejection and Total Mood Disturbance scores, when compared between pre- and post-intervention, while the placebo group did not. In conclusion, the oral administration of 5-ALA improves fatigue and negative mood in subjects who constantly feel physical fatigue. This clinical trial was registered with University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) as UMIN000031528 on 2/3/2018.
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Affiliation(s)
- Fumiko Higashikawa
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551, Japan
| | - Keishi Kanno
- Department of General Internal Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan
| | - Akiko Ogata
- Department of Psychology, Graduate School of Education, Hiroshima University, 1-1-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, 739-8511, Japan
| | - Masanori Sugiyama
- Department of Probiotic Science for Preventive Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551, Japan.
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Abstract
Pain is an important and frequent symptom in multiple sclerosis (MS), which leads to a low quality of life, increased disability level, and lack of employment and mental health. Recently, studies have shown increased interest in pain in MS and there is a growing evidence of its prevalence. However, the literature suffers from lack of experimental studies focusing on pain reduction. This topical review summarizes the current knowledge about pain in MS with its definitions, assessments, treatments and rehabilitation within a holistic perspective.
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Affiliation(s)
- Cigdem Yilmazer
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, UHasselt, Diepenbeek, Belgium
| | - Ilse Lamers
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, UHasselt, Diepenbeek, Belgium/Rehabilitation and MS Center, Pelt, Belgium /University MS Center, UHasselt, Diepenbeek, Belgium
| | - Claudio Solaro
- Department of Rehabilitation, Associazione Silenziosi Operai della Croce, Onlus, Moncrivello, Italy
| | - Peter Feys
- Rehabilitation Research Center (REVAL), Faculty of Rehabilitation Sciences, UHasselt, Diepenbeek, Belgium//University MS Center, UHasselt, Diepenbeek, Belgium
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14
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Kozinc Ž, Baltrusch S, Houdijk H, Šarabon N. Reliability of a battery of tests for functional evaluation of trunk exoskeletons. APPLIED ERGONOMICS 2020; 86:103117. [PMID: 32342882 DOI: 10.1016/j.apergo.2020.103117] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 03/26/2020] [Accepted: 04/06/2020] [Indexed: 06/11/2023]
Abstract
Recently, several spinal exoskeletons were developed with the aim to assist occupational tasks such as load-handling and work in prolonged static postures. While the biomechanical effects of such devices has been well investigated, only limited feedback to the developers is usually provided regarding the subjective perceptions of the end-users. The aim of this study was to present a novel battery of tests, designed to assess functional performance and subjective outcomes during the use of assistive trunk exoskeletons, and to assess its test-retest reliability. The battery of tests consists of 12 different simple functional tasks. Twenty participants were included in an intra-session reliability test and repeated the tests within 7-10 days to assess inter-session reliability. They were wearing a novel passive spinal exoskeleton during all trials. The outcomes included quantitative and subjective measures, such as performance time and rating of discomfort and perceived task difficulty. The majority of the outcome measures were reliable within session and between sessions (ICC or α > 0.80). Systematic effects were observed in a few tasks, suggesting that familiarization trials will be needed to minimize the learning effects. The novel battery of tests could become an important easy-to-use tool for functional testing of the spinal exoskeletons in addition to more specific biomechanical and physiological testing. Further studies should address the reliability of the present battery of tests for assessing specific populations, such as low back pain patients and explore how to minimize systematic effects that were observed in this study.
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Affiliation(s)
- Žiga Kozinc
- University of Primorska, Andrej Marusic Institute, Department of Health Study, Koper, Slovenia; University of Primorska, Faculty of Health Sciences, Department of Kinesiology and Physiotherapy, Koper, Slovenia
| | - Saskia Baltrusch
- Research and Development, Rehabilitation Centre Heliomare, Wijk aan Zee, the Netherlands; Amsterdam Movement Sciences, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - Han Houdijk
- Research and Development, Rehabilitation Centre Heliomare, Wijk aan Zee, the Netherlands; Amsterdam Movement Sciences, Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - Nejc Šarabon
- University of Primorska, Faculty of Health Sciences, Department of Kinesiology and Physiotherapy, Koper, Slovenia; S2P, Science to Practice, Ltd, Laboratory for Motor Control and Motor Behaviour, Ljubljana, Slovenia.
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15
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Ifantopoulou P, Artemiadis AK, Bakirtzis C, Zekiou K, Papadopoulos TS, Diakogiannis I, Hadjigeorgiou G, Grigoriadis N, Orologas A. Cognitive and brain reserve in multiple sclerosis––A cross-sectional study. Mult Scler Relat Disord 2019; 35:128-134. [DOI: 10.1016/j.msard.2019.07.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 06/29/2019] [Accepted: 07/27/2019] [Indexed: 10/26/2022]
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16
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Midaglia L, Mulero P, Montalban X, Graves J, Hauser SL, Julian L, Baker M, Schadrack J, Gossens C, Scotland A, Lipsmeier F, van Beek J, Bernasconi C, Belachew S, Lindemann M. Adherence and Satisfaction of Smartphone- and Smartwatch-Based Remote Active Testing and Passive Monitoring in People With Multiple Sclerosis: Nonrandomized Interventional Feasibility Study. J Med Internet Res 2019; 21:e14863. [PMID: 31471961 PMCID: PMC6743265 DOI: 10.2196/14863] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 07/11/2019] [Accepted: 07/19/2019] [Indexed: 12/04/2022] Open
Abstract
Background Current clinical assessments of people with multiple sclerosis are episodic and may miss critical features of functional fluctuations between visits. Objective The goal of the research was to assess the feasibility of remote active testing and passive monitoring using smartphones and smartwatch technology in people with multiple sclerosis with respect to adherence and satisfaction with the FLOODLIGHT test battery. Methods People with multiple sclerosis (aged 20 to 57 years; Expanded Disability Status Scale 0-5.5; n=76) and healthy controls (n=25) performed the FLOODLIGHT test battery, comprising active tests (daily, weekly, every two weeks, or on demand) and passive monitoring (sensor-based gait and mobility) for 24 weeks using a smartphone and smartwatch. The primary analysis assessed adherence (proportion of weeks with at least 3 days of completed testing and 4 hours per day passive monitoring) and questionnaire-based satisfaction. In-clinic assessments (clinical and magnetic resonance imaging) were performed. Results People with multiple sclerosis showed 70% (16.68/24 weeks) adherence to active tests and 79% (18.89/24 weeks) to passive monitoring; satisfaction score was on average 73.7 out of 100. Neither adherence nor satisfaction was associated with specific population characteristics. Test-battery assessments had an at least acceptable impact on daily activities in over 80% (61/72) of people with multiple sclerosis. Conclusions People with multiple sclerosis were engaged and satisfied with the FLOODLIGHT test battery. FLOODLIGHT sensor-based measures may enable continuous assessment of multiple sclerosis disease in clinical trials and real-world settings. Trial Registration ClinicalTrials.gov: NCT02952911; https://clinicaltrials.gov/ct2/show/NCT02952911
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Affiliation(s)
- Luciana Midaglia
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia, Vall d'Hebron University Hospital, Barcelona, Spain.,Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
| | - Patricia Mulero
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Xavier Montalban
- Department of Neurology-Neuroimmunology, Multiple Sclerosis Centre of Catalonia, Vall d'Hebron University Hospital, Barcelona, Spain.,Division of Neurology, University of Toronto, Toronto, ON, Canada
| | - Jennifer Graves
- Department of Neurology, University of California, San Diego, San Diego, CA, United States
| | - Stephen L Hauser
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Laura Julian
- Genentech Inc, South San Francisco, CA, United States
| | | | | | | | | | | | | | | | | | - Michael Lindemann
- F Hoffmann-La Roche Ltd, Basel, Switzerland.,Department of Economics, Baden-Wuerttemberg Cooperative State University, Loerrach, Germany
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Chalah MA, Kauv P, Créange A, Hodel J, Lefaucheur JP, Ayache SS. Neurophysiological, radiological and neuropsychological evaluation of fatigue in multiple sclerosis. Mult Scler Relat Disord 2019; 28:145-152. [DOI: 10.1016/j.msard.2018.12.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 12/22/2022]
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18
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Artemiadis AK, Anagnostouli MC, Zalonis IG, Chairopoulos KG, Triantafyllou NI. Structural MRI Correlates of Cognitive Event-Related Potentials in Multiple Sclerosis. J Clin Neurophysiol 2018; 35:399-407. [DOI: 10.1097/wnp.0000000000000473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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19
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Artemiadis A, Anagnostouli M, Zalonis I, Chairopoulos K, Triantafyllou N. Structural MRI correlates of cognitive function in multiple sclerosis. Mult Scler Relat Disord 2018; 21:1-8. [PMID: 29438835 DOI: 10.1016/j.msard.2018.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 02/03/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Cognitive impairment (CI) has been associated with numerous magnetic resonance imaging (MRI) indices in multiple sclerosis (MS) patients. In this study we investigated the association of a large set of 2D and 3D MRI markers with cognitive function in MS. METHODS A sample of 61 RRMS patients (mean age 41.8 ± 10.6 years old, 44 women, mean disease duration 137.9 ± 83.9 months) along with 51 age and gender matched healthy controls was used in this cross-sectional study. Neuropsychological and other tests, along with a large set of 2D/3D MRI evaluations were made. RESULTS 44.3% of patients had CI. CI patients had more disability, physical fatigue than non-CI patients and more psychological distress than non-CI patients and HCs. Also, CI patients had significantly larger third ventricle width and volume, smaller coprus callosum index and larger lesion volume than non-CI patients. These MRI markers also significantly predicted cognitive scores after adjusting for age and education, explaining about 30.6% of the variance of the total cognitive score. CONCLUSIONS Selected linear and volumetric MRI indices predict cognitive function in MS. Future studies should expand these results by exploring longitudinal changes and producing normative data.
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Affiliation(s)
- Artemios Artemiadis
- 1st Department of Neurology, Aeginition Hospital, Faculty of Medicine, National Kapodistrian University of Athens, Vas. Sofias Ave. 72-74, GR-11528 Athens, Greece; Department of Neurology, Army Share Fund Hospital (NIMTS), Monis Petraki 10-12, GR-11521 Athens, Greece.
| | - Maria Anagnostouli
- 1st Department of Neurology, Aeginition Hospital, Faculty of Medicine, National Kapodistrian University of Athens, Vas. Sofias Ave. 72-74, GR-11528 Athens, Greece
| | - Ioannis Zalonis
- 1st Department of Neurology, Aeginition Hospital, Faculty of Medicine, National Kapodistrian University of Athens, Vas. Sofias Ave. 72-74, GR-11528 Athens, Greece
| | - Konstantinos Chairopoulos
- Department of Neurology, Army Share Fund Hospital (NIMTS), Monis Petraki 10-12, GR-11521 Athens, Greece
| | - Nikos Triantafyllou
- 1st Department of Neurology, Aeginition Hospital, Faculty of Medicine, National Kapodistrian University of Athens, Vas. Sofias Ave. 72-74, GR-11528 Athens, Greece
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